What is CMS?

Bocephus71RN-BSN, BSN, RN · Jan 21, 2008

Yes that is correct. I document it as CMS is within normal limits or CMS intact. However, if there was a deviance from normal you would document what is abnormal such as pulse not palpable or cap refill>3 secs, or pt. unable to move phalanges etc. Hope that helps. It's a quick way to document that you did a neurovascular check and everything was within normal.

kmoonshine, RN · Jan 21, 2008

I've always known it to be "CMTS" (color, motion, temperature, sensation).

You could document:

(For restraint application): "CMTS intact in all 4 extremities distal to restraint application; pt able to move fingers with full ROM of bilateral wrists and bilateral feet; unable to abduct arms and legs secondary to restraint application, no c/o pain or irritation at restraint site per pt."

(For right shoulder injury): "CMTS intact distal to R shoulder injury with CMTS equal in bliateral upper extremities".

(For right forearm fx): "CMTS compromised in R forearm distal to injury site; color pale, decreased ROM, skin cool, and decreased sensation noted in affected extremity when compared to L arm".

(For R leg cellulitis): "CMTS altered in R lower extremity: skin reddened, decreased ROM noted, skin hot to touch; pt c/o altered sensation ("tingling") upon palpation, pedal pulses +2 bilaterally. CMTS intact in L lower extremity".

Bocephus71RN-BSN, BSN, RN · Jan 22, 2008

CMS as I was taught is related to circulation, motion and sensation. However maybe in the ER the abbreviation is different. For example, if a pt. has a cast placed proximally you would want to assess neurovascular function which would include circulation and not color. Whether or not the fingers have capillary refill or if a pulse is present distal to the cast, or in the case that someone has trauma and you are doing a neurovascular assessment to make sure they are not developing compartment syndrome. In which case color and temperature are moot points, you would be testing for circulation first. However, if the extremity was cyanotic and cold to touch this is indicative that circulation is impaired, but the hospitals I've worked at it was related directly to circulation (ie. if pulses are present or not and the grade of the pulses if palpable or heard via doppler or capillary refill being.

kmoonshine, RN · Jan 22, 2008

Bocephus71RN-BSN said:

CMS as I was taught is related to circulation, motion and sensation. However maybe in the ER the abbreviation is different. For example, if a pt. has a cast placed proximally you would want to assess neurovascular function which would include circulation and not color. Whether or not the fingers have capillary refill or if a pulse is present distal to the cast, or in the case that someone has trauma and you are doing a neurovascular assessment to make sure they are not developing compartment syndrome. In which case color and temperature are moot points, you would be testing for circulation first. However, if the extremity was cyanotic and cold to touch this is indicative that circulation is impaired, but the hospitals I've worked at it was related directly to circulation (ie. if pulses are present or not and the grade of the pulses if palpable or heard via doppler or capillary refill being

CMTS is just another way of assessing CMS; just the abbreviation is somewhat different. See, when you assess circulation using capillary refill (a measure of peripheral perfusion), you press the nailbed until it is white, then assess the time it takes for the color to return to normal. Or, like you said, a patient who has cold, cyanotic extremities has some alteration in circulation. I personally like using CMTS because I think color and temperature are important - but you are right, color and temperature are only two components of circulation. Assessing pulses is an essential component which objectively measures blood flow (rather than saying "pt's right arm appears pale" - what's pale to me may not be pale to someone else). Perhaps I should call it "CCMTS" (circulation, color, motion, temperature, sensation)?

CMTS works for me, and perhaps others prefer CMS. Thanks for pointing out the differences. Assessing pulses is EXTREMELY important, and I should have emphasized that more.